Vitals question

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Specializes in Cardiology, School Nursing, General.

There's a post here and some people were commenting on vitals and how they do it. What's your method? I basically just check temps if it's something related to fevers, like colds or headaches, or if the child says they feel "hot". I'm not sure of full vitals though, when do you do these? I do hear chests if the child says their chest hurts and such, but I'm not sure what else I can do for vitals.

How do you guys do it?

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Specializes in School health, pediatrics.

Are you trained to listen to breath sounds? I am not, so if I have someone I am worried about I call the district RN. I just get temps, sometimes a pulse. Occasionally I'll get a pulse-ox to reassure a student that they are getting enough air on rare occasion (frequent fliers). If I get a pulse it's often to report it to EMS when they arrive.

Unless you have an order with protocol for what to do, I would not obtain the vital.

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Specializes in ICU/community health/school nursing.

What does your certification allow you to do and what have you been trained to do?

My unlicensed clinic aide has been trained to take temp, use the BP "machine", and use a pulse oximiter. She does not count respirations. She doesn't take a manual pulse. She does not auscultate breath sounds and cannot differentiate heart rhythm...although she knows that over 100 means something needs to be done.

She only does this when I am away from the office (as in, she'll start and I usually double check). If there was no nurse here, she is instructed to call EMS.

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Specializes in NCSN.

I'm not sure of what your scope includes A, so like Ohio said above, I would get that clarified before doing a full set of vitals.

Every visit is different for me, except everyone gets a temp check. I probably listen to breath and bowel sounds more than needed, but I feel like lately a lot of my "stomach aches" are actually just a side effect from excessive coughing or just hunger. I take BPs for dizziness, first time headaches. Neuro checks for head injuries. The ones who stump me (non FFs with odd symptoms) get a head to toe.

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Specializes in Cardiology, School Nursing, General.

I am trained in EVERYTHING. Basically l know how to listen to heart rhythms, breath sounds, BP, Pulse Oximeter, temp, manual pulse, etc.

*If you are in Houston,Texas and in need of a Medical Aide for you school, PM me btw.*

I can do all this, but I'm not sure when to do this, or when I'm over reacting on something.

I only do vitals if there's an emergency or something is going on. But if the child has chest pains or anything like that I do hear their chest. I don't use my pulse oximeter much, because it seems to act up sometimes and I can get a better reading doing respiration counts myself.

Here's an example:

I had a student who came to me because she felt dizzy. I checked her vitals, basically heart rhythm, respiration, BP, pulse oximeter, manual pulse. Was sent home. She was fine in that, and later I learned this girl was lying just to get out of class, but I did my protocol.

I had a student who came with chest pains, has a history of heart issues. Heart rate was good, heart rhythm sounded good, respiration, BP and oximeter said he was fine. Mother just asked him to rest for a while and he felt better after a rest.

I just a student come in because a nasal congestion and cough, checked temp, normal. (98.3). Informed mother, went home.

Abdominal is something I was taught but I'm not good at, so I just go by asking where does their stomach hurt. (Below belly button (if female poss. cramps) or around belly button, possibly needs to go to the restroom. Above belly button, possibly hungry or ate something that doesn't work for them, get a drink of water. Nothing works, I inform parents anyways to ask them to see what they would they want to do with them.

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Specializes in School health, pediatrics.

I would review your scope. Here in Ohio anything I do is delegated to me, which means a physician or nurse tells me what to do, and what to do with the results. So if I listen to heart rhythm and it is off, do I have protocol for what to do? My RN and organization do not want me doing these things. It is not delegated, so I do not. None of my procedures indicate more than a temp check, really.

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Specializes in Cardiology, School Nursing, General.
I would review your scope. Here in Ohio anything I do is delegated to me, which means a physician or nurse tells me what to do, and what to do with the results. So if I listen to heart rhythm and it is off, do I have protocol for what to do? My RN and organization do not want me doing these things. It is not delegated, so I do not. None of my procedures indicate more than a temp check, really.

Here in Texas I can do anything a nurse can do as long as I was trained or taught and I'm under supervision of a RN, NP or MD, or given permission to do so. I can't diagnose obviously, but I can do vitals and such, and that's it.

That's all I do basically, vitals, inform parents and if the parents want to take them home or not, that's their responsibility.

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Specializes in School Nurse.
I am trained in EVERYTHING. Basically l know how to listen to heart rhythms, breath sounds, BP, Pulse Oximeter, temp, manual pulse, etc.

I only do vitals if there's an emergency or something is going on. But if the child has chest pains or anything like that I do hear their chest. I don't use my pulse oximeter much, because it seems to act up sometimes and I can get a better reading doing respiration counts myself.

Here's an example:

I had a student who came to me because she felt dizzy. I checked her vitals, basically heart rhythm, respiration, BP, pulse oximeter, manual pulse. Was sent home. She was fine in that, and later I learned this girl was lying just to get out of class, but I did my protocol.

Abdominal is something I was taught but I'm not good at, so I just go by asking where does their stomach hurt. (Below belly button (if female poss. cramps) or around belly button, possibly needs to go to the restroom. Above belly button, possibly hungry or ate something that doesn't work for them, get a drink of water. Nothing works, I inform parents anyways to ask them to see what they would they want to do with them.

A pulse ox checks the oxygenation of a patient and in no way could you ever "get a better reading doing respiration counts myself" A pulse ox will also check heart rates and does not do "respiration counts." Maybe that is why you are not utilizing this tool well.

Heart rhythms are different from heart rates or the pulse and we auscultate those.

Abdomens have 4 quadrants that Nurses auscultate.

You have an RN that supervises you and trained you?

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Specializes in Med-surg, school nursing..

I haven't read other posts so forgive me if I am repeating.

I check temps for any stomachache, earache, headache, sore throat, or just blah.

O2: Feelings of SOA, persistent cough, dizziness (just as a CYA)

HR: same as O2 because of the pulse ox ;)

BP: True feelings of dizziness or a student just doesn't look right. Feelings of being hot all of a sudden, and occasionally if there's a really bad headache with flushed face but no fever.

RR: Asthma kiddos if they are struggling or my anxiety kids.

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Specializes in Cardiology, School Nursing, General.
A pulse ox checks the oxygenation of a patient and in no way could you ever "get a better reading doing respiration counts myself" A pulse ox will also check heart rates and does not do "respiration counts." Maybe that is why you are not utilizing this tool well.

Heart rhythms are different from heart rates or the pulse and we auscultate those.

I'm sorry. I mis wrote that. I meant to say the heart rate not the respirations. I know it doesn't do respiration, that's my mistake. I meant the pulse. The pulse ox is old and sometimes I think it doesn't work with pulse, as well with ox. When I used it before it sometimes would say the student had 114 of pulse, but when I did it manually it would be 94. I do use it for pulse ox, but I have to squeeze it for it read well.

I might have to get a new one or change the batteries I believe.

Heart rhythms I know it's different from heart rates and pulse, but I do listen to them to if the child says their chest hurts.

Sorry for writing it wrong, I wasn't paying attention what I was writing.

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Specializes in Cardiology, School Nursing, General.
I haven't read other posts so forgive me if I am repeating.

I check temps for any stomachache, earache, headache, sore throat, or just blah.

O2: Feelings of SOA, persistent cough, dizziness (just as a CYA)

HR: same as O2 because of the pulse ox ;)

BP: True feelings of dizziness or a student just doesn't look right. Feelings of being hot all of a sudden, and occasionally if there's a really bad headache with flushed face but no fever.

RR: Asthma kiddos if they are struggling or my anxiety kids.

No this is what I was looking for as an answer. I do temps like you, but not for stomach aches, unless the student looks really bad.

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Specializes in School health, pediatrics.
I do temps like you, but not for stomach aches, unless the student looks really bad.

Why not a temp on a stomach ache? Thats one of the few things I always get a temp on. Sorethroat, stoamch ache. Temp temp.

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